Healthcare Provider Details

I. General information

NPI: 1104344225
Provider Name (Legal Business Name): RELAX BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2017
Last Update Date: 07/15/2024
Certification Date: 07/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2809 POINSETTIA AVE STE 1,2&6
WEST PALM BEACH FL
33407-5426
US

IV. Provider business mailing address

2809 POINSETTIA AVE STE 12&6
WEST PALM BEACH FL
33407-5426
US

V. Phone/Fax

Practice location:
  • Phone: 561-469-9934
  • Fax:
Mailing address:
  • Phone: 561-469-9934
  • Fax: 888-972-4983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number11045
License Number StateFL

VIII. Authorized Official

Name: KEREN MARIE ROESSER
Title or Position: MANAGING MEMBER
Credential: LMHC CAP SAP CRC LPN
Phone: 561-398-8336